Epidural Anesthesia for Cesarean Section

Abstract

Three groups of patients undergoing elective cesarean section during lumbar epidural anesthesia with bupivacaine, 0.75% (15 patients), chloroprocaine, 3% (15 patients) or etidocaine, 1% (10 patients) were studied. Excellent sensory and motor block were obtained with chloroprocaine and bupivacaine; sensory anesthesia was inadequate with etidocaine in most patients. Onset of anesthesia, induction-delivery interval and stay in the recovery room were all longer with bupivacaine when compared with chloroprocaine. Fetal outcome, as determined by Apgar scores, acid-base status and neurobehavioral testing, was equally good in all groups. At delivery, fetal/maternal concentration ratio of bupivacaine was 0.31 and that of etidocaine, 0.25. The umbilical artery-umbilical vein blood concentration difference for etidocaine was significantly higher than that for bupivacaine. Excellent clinical results were obtained using bupivacaine, 0.75% alone, or chloroprocaine, 3%, for induction and maintenance of anesthesia, supplemented with bupivacaine, 0.25%, before removal of the catheter.